The present invention relates generally to data processing systems, methods and computer program products and, more particularly, to medical data processing systems, methods and computer program products.
Chronic disease management conventionally involves routinely monitoring patients to identify health problems before they become medically severe. Chronic disease management may also involve monitoring exercise and diet patterns of patients, as well as adherence to and adjustments of prescribed medicine. A chronic disease that is a major health problem in the United States, and one that often reduces the life span of those who suffer from it, is diabetes mellitus. Diabetes mellitus relates to a group of disorders in which the human body does not produce sufficient insulin and, as a result, blood sugar is elevated. Diabetes management conventionally includes monitoring a patient""s blood glucose for abnormalities; monitoring preventative health behaviors such as weight control and fat intake; and monitoring adherence to scheduled insulin regimens.
An important advance in diabetes treatment has been the advent of home blood glucose monitoring wherein glucose meters are used by patients to self-test blood-glucose levels. However, control of blood glucose may require that patients measure their blood sugar 3-4 times per day, record the data, use the data in a formula to adjust their insulin dosage, and frequently communicate the data to a physician or nurse to evaluate their progress. Unfortunately, physicians may not have the time required to review blood glucose data from patients on a regular basis, or to educate and/or motivate patients to follow complicated self-care regimens. Furthermore, some physicians may consider data obtained by patients unreliable and may require patients to come in for an office visit for testing. Requiring patients to make office visits may increase the cost of health care, and may reduce the likelihood that frequent (i.e., daily) adjustments to insulin levels are made.
To overcome the disadvantages of requiring diabetes patients to visit a physician""s office, various health care organizations have implemented programs where case managers (i.e., persons with some level of medical training) telephone patients periodically to obtain blood glucose data and other information and to coordinate care. Unfortunately, with often hundreds of patients per case manager, personal contact with individual patients on a daily or even regular basis may be difficult. In addition, personal contact with individual patients on a regular basis may be somewhat expensive. Accordingly, case managers using conventional management techniques may not be able to adjust a patient""s insulin dosage as often as necessary to adequately control blood glucose level.
In addition, patients with diabetes may often need feedback and encouragement to continue testing their glucose levels and reporting results to a case manager. Without regular positive feedback, patients may not perform self-tests with enough regularity or may not conduct tests properly.
Another approach used in chronic disease management involves automated voice messaging (AVM) services, wherein patients receive regular telephone calls providing various educational and motivational messages from case managers. Exemplary messages may include reminding a patient of a scheduled physician visit. Some AVM services involve one-way communication, wherein a recorded message is delivered to a patient, but no information is obtained from the patient. As a result, the medical condition of a patient may not be available unless the patient is examined in-person by a physician.
AVM services involving two-way communications may allow patients to respond to AVM telephone queries via a touch tone telephone. Information received from patients may be reviewed by a case manager. The case manager then may identify which patients require callbacks for gathering more detailed information, discussing problems, or providing further information. Unfortunately, AVM services involving two-way communications may require some level of human intervention to identify patients with medically severe conditions that require medical attention, such as a change in insulin dosage. Chronic disease management via AVM has another drawback in that delays may occur between the identification of a patient with a medically severe condition and actual treatment of the condition.
In view of the above discussion, it is an object of the present invention to allow health care providers to quickly and easily monitor many patients simultaneously and to automatically identify patients with medical conditions and to organize identified medical conditions by severity.
It is yet another object of the present invention to allow health care providers to quickly prepare revised medicine dosages for patients and quickly communicate revised dosage information to patients.
It is also an object of the present invention to facilitate effective patient behavior modification in remotely located patients by providing timely rewards for correct behavior.
These and other objects of the present invention are provided by methods, systems and computer program products for monitoring, diagnosing, prioritizing and treating medical conditions of a plurality of remotely located patients undergoing anticoagulation therapy using a central data processing system configured to communicate with and receive data from a plurality of respective patient monitoring systems. Patient monitoring systems are capable of receiving and storing patient data and may include a medicine dosage algorithm for using the stored patient data to generate medicine dosage recommendations to a patient.
A central data processing system may be configured to obtain patient data from each patient monitoring system, to analyze the obtained patient data, and to identify medical conditions requiring medical attention. A central data processing system may also implement medication dosage algorithms in cases where these algorithms are not a feature offered by patient monitoring systems.
Data transmitted from a patient monitoring system may be analyzed substantially simultaneously with the transmission thereof to the central data processing system to identify emergency medical conditions requiring immediate medical attention. For identified emergency medical conditions, treatment information and altered self-monitoring instructions and/or prompts may be automatically communicated to the respective patient monitoring system.
Identified patient medical conditions for each respective patient are displayed in selectable, prioritized order according to medical severity via one or more remotely located client machines (hereinafter xe2x80x9cclientsxe2x80x9d) in communication with a central data processing system. In response to a user (e.g., a case manager, physician, nurse) selecting an identified medical condition for a respective patient, treatment options for treating the medical condition may be displayed on the client.
A user may communicate treatment information to a respective patient via a variety of methods including, but not limited to, wireless, satellite, telephone, AVM, e-mail, or facsimile transmission. In addition, the present invention allows a user to communicate treatment information directly from a client to a respective patient monitoring system or within a central data processing system. A user may modify a medicine dosage algorithm stored within a respective patient monitoring system or within a central data processing system. In addition to modifying dosage algorithms, a user may modify medicine doses and fixed or contingent self-monitoring schedules for a patient. The present invention also tracks each identified medical condition for each patient from identification to resolution. The present invention tracks whether a user has communicated treatment information to a patient regarding an identified medical condition. In addition, the present invention tracks whether a patient has performed actions associated with treatment recommended by a user.
According to another aspect of the present invention, patient monitoring devices for monitoring medical conditions of a patient are configured to receive, store and analyze patient-obtained data. For example, a patient may take a blood sample and have the sample analyzed and stored within a device. Patient monitoring devices are configured to communicate with and transmit stored patient data to a central data processing system. Patient monitoring devices are also configured to receive treatment information from the central data processing system. For example, information may be displayed to a patient via a patient monitoring device. In addition, a medicine dosage algorithm may be stored within a patient monitoring device and may be modified via a central data processing system to adjust a patient""s medicine dosage.
According to another aspect of the present invention, a system for monitoring medical conditions of a plurality of remotely located patients includes a central data processing system configured to communicate with a plurality of remotely located patient monitoring systems and at least one remotely located client in communication with the central data processing system. A central data processing system is configured to obtain patient data from each remotely located patient monitoring system and to analyze the obtained patient data to identify medical conditions of each respective patient. Identified patient medical conditions for each respective patient may be displayed to a user in selectable, prioritized order according to medical severity via a remotely located client. By selecting a particular medical condition for a patient, treatment options for treating the selected medical condition may be displayed to the user.
A central data processing system, according to the present invention, is configured to allow a user to communicate treatment information to a respective patient via a client in various methods through the central data processing system, including, but not limited to, wireless, satellite, telephone, AVM, e-mail, or facsimile transmission. A user may also transmit motivational and other behavior-modification information to a patient via a client through the central data processing system. In addition, a central data processing system is configured to allow a user to transmit treatment information directly to a patient""s remotely located patient monitoring system via a client. For example, modifications may be made directly to a medicine dosage algorithm stored within a respective patient monitoring system.
A central data processing system, according to the present invention, may also be configured to analyze data transmitted from a patient monitoring system substantially simultaneously with the transmission thereof to identify emergency medical conditions requiring immediate medical attention or to calculate a new medication dosage according to a physician-prescribed algorithm. In response to identifying an emergency medical condition, treatment information may be automatically communicated to the respective patient monitoring system while communications are still established.
The present invention is advantageous because physicians and other health care providers can remotely monitor, identify and treat patient medical problems, thereby obviating the need for frequent patient visits and telephone calls. The present invention facilitates automation of various aspects of patient treatment. In addition, physicians and case managers utilizing the present invention are able to quickly identify patients with medical conditions requiring immediate attention from a patient population of thousands or more. For example, the present invention can regulate warfarin dosage without requiring patients to be seen by a physician. A patient""s progress can be continuously monitored and changes can be made to a patient""s warfarin dosage, to a patient""s dosage algorithm, and to a patient""s fixed or contingent self-monitoring scheduling as often as necessary.
Using the present invention, anticoagulation therapy patients can transmit data to a central data processing system at specified intervals and the data can be analyzed to detect trends and problems. If a problem with a particular patient is detected, a revised warfarin (or other anticoagulation medicine) algorithm, a revised warfarin (or other anticoagulation medicine) dosage, and a revised fixed or contingent self-monitoring schedule can be downloaded to that patient""s monitoring system, or can be transmitted directly to the patient. In addition the patient can be notified either by telephone, AVM, e-mail or fax to seek immediate medical attention if necessary.
The present invention is particularly well-suited for facilitating patient behavior modification. Through prompts and useful feedback, the present invention can reward patients for proper self care behavior.